We read the article by Pang et al1 concerning the use of frog skin for the differentiation of bullous pemphigoid (BP) from epidermolysis bullosa acquisita (EBA). Based on sporadic observations of a floor-pattern indirect immunofluorescence on 1 mol/L of sodium chloride—split skin (SSS) obtained from BP sera, these authors used skin from a toad to establish a differential diagnosis between BP and EBA. Their rationale was the fact that, as suggested by earlier studies, the BP antigen is present in the skin of some animals,2 from which the EBA antigen—being phylogenetically more restricted—is absent.3 Since this procedure seems attractive, we undertook a retrospective comparative study to better delineate the usefulness of animal skin substrates for the diagnosis, using indirect immunofluorescence, of subepidermal autoimmune bullous diseases.
During the last 3 years, we screened over 1500 human serum samples sent to us under the suspicion of a subepidermal autoimmune
Kanitakis J, Cozzani E, Peyron E, Bourchany D, Claudy A. Use of Animal Skin Substrates for Indirect Immunofluorescence Diagnosis of Subepidermal Autoimmune Bullous Diseases. Arch Dermatol. 1994;130(12):1558. doi:10.1001/archderm.1994.01690120102017